Outpatient Facility Coding Alert - 2003 Issue 24
Fraud & Abuse: LIE TO AN AUDITOR, LINGER IN JAIL
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Article Overview
This article discusses a federal appellate decision in a health care fraud case involving Medicare and Medicaid audit conduct. It is relevant to compliance, audit response, and fraud-and-abuse audiences who want a high-level understanding of how misleading auditors can affect criminal sentencing.
Why This Topic Matters
The piece highlights the compliance risks associated with inaccurate statements during Medicare and Medicaid audit processes and shows how audit-related conduct can have broader legal consequences.
What You Will Learn
- How a fraud-and-abuse appellate decision relates to Medicare and Medicaid audit activity
- Why audit communications can matter in a broader criminal enforcement context
- What kinds of compliance issues may arise in provider billing and transportation-related review situations
- How fraud, obstruction, and audit conduct can intersect in a health care enforcement case
Who Should Read This
- Health care compliance professionals
- Medical coders
- Billing staff
- Ambulance and transportation providers
- Risk management professionals
- Health care attorneys
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